Online Appraisal Order Form

Order Placed By:
Company Name:
Company Address:
City/ST/Zip:	/ /
Company Phone:
Company Fax:
Company E-Mail:
Loan Officer :

**Please complete an appraisal for the following:**
Borrower / Contact Person:
Property Address:
City:
Legal Description:
Home Phone:
Work Phone:

Property Type:
Appraisal Type:
FHA Case #
Sales Price:
Selling Realtor:
Purchase or Refinance:	Purchase
Purchase or Refinance:	Refinance
( Please fax or e-mail Purchase Agreement )

Please include further instructions for appraiser:

For your convenience and records, a copy of the completed form will be sent to the email address that you specified above. Please take time to verify this address before submitting appraisal request.